International governance structures for health-care waste management: A systematic review of scientific literature

•We systematically review scientific literature about health-care waste management.•We identify and discuss gaps, trends, efforts, and key-factors.•We suggest areas for improvement and best practices reported in literature.•We include recommendations for policy makers, practitioners and researchers.•We promote a holistic and harmonized approach to health-care waste management.

Significant differences exist in the management of health-care waste management, globally. This is particularly so between low, middle and high-income countries. A systematic review of scientific literature on global healthcare waste management spanning the period 2000 – current was undertaken, in order to identify key policies, practices, challenges and best practice. The findings were analysed considering the Gross National Income and the Human Development Index of each country. Effective regulation and operative definitions of waste categories are key-factors requiring improvement at the national level. The economic conditions in the country are an important factor, especially regarding treatment and disposal. Areas for improvement (e.g. the need for improved governance structures, the development of regional clusters, as well as sharps waste segregation) are suggested.